Access to effective rehabilitation delivered by physiotherapists is essential for people recovering from bone and joint injuries - but they do not always get it.

"In the case of hip fractures among elderly patients, rehabilitation should be aimed at improving strength, balance and endurance, and restoring them to the level of fitness they had before the operation, but research has shown that this only happens in 30% of cases," says Ruth ten Hove, head of research at the Chartered Society of Physiotherapy (CSP).

The CSP recommends that patients with hip fractures start rehabilitation on the day after their operation and this should daily until they have reached their goals. That is relatively easily achieved in hospital but once patients are discharged into the community, access to rehabilitation services are patchy.

"Our nationwide survey found that well-designed and appropriately-funded physiotherapy services, offered seven days a week, provide excellent rehabilitation for patients recovering from a hip fracture. However for most people, when they left hospital there was no clear standard rehabilitation pathway. In some cases patients could not access rehabilitation at all, or they could not access enough.

"Often they faced a wait while their GPs referred them to community physiotherapists. As a patient group they will deteriorate quickly, if not able to access the right services," says ten Hove

"Hip fractures cost society £2 billion a year, much of the bill is accounted for by social care, as patients who have had insufficient rehabilitation can end up in residential care, all because of poor access to services in the community. It's disgraceful," says ten Hove.

There is also good evidence that timely, appropriate physiotherapy for people who are at risk of falls, improves strength, balance and flexibility so people are more likely to remain mobile and active and suffer fewer falls. "This enables people to remain independent for longer and saves taxpayers money in the long run," says ten Hove

Access to high quality physiotherapy is also essential to recovery after sports injuries, says ten Hove. The specific physiotherapy really depends on the type of injury, but the focus is always to optimise recovery, to get the patient back to their normal levels of health and fitness and to reduce their risks of further injury. Physiotherapy may start whilst someone is in hospital, continue at home and onto the sports field.

Regardless of the cause or type of bone or joint injury, a poor recovery caused by lack of effective physiotherapy, can result in weakness in the limb or joint that is may increases the risk of osteoarthritis.

She advises people who have suffered bone and joint trauma to find out what rehabilitation services they are entitled to and press to receive them.